Provider Demographics
NPI:1326785288
Name:COLES, VICTORIA JEAN
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:JEAN
Last Name:COLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WATER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-1237
Mailing Address - Country:US
Mailing Address - Phone:814-283-5535
Mailing Address - Fax:
Practice Address - Street 1:16 WATER ST STE 101
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-1237
Practice Address - Country:US
Practice Address - Phone:814-283-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health